Intramural tubal polyps--a villain in the shadows?
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Abstract:
Intramural tubal polyps are commonly described in association with subfertility. However, there is unfamiliarity among clinicians about the investigations available for making a diagnosis of this condition. The objective of this paper was to highlight the suitable investigations for diagnosis and thus increase awareness of this condition and its relationship with subfertility.A retrospective review of 14 patients with intramural tubal polyps was done for the period from January to December 1996. An attempt was made to correlate the radiographic findings on hysterosalpingography with transvaginal ultrasound examinations and hydrochromotubation performed under laparoscopic observation. The fertility history of these patients was also examined.The review demonstrated a prevalence of 3.8% of intramural tubal polyps in a selected population of predominantly subfertile women. Only hysterosalpingography was useful in making the diagnosis in-vivo. Fifty percent of the patients did not have any other obvious pathology to explain their subfertility.We conclude that meticulous hysterosalpingography is useful as a diagnostic investigation and that consistent reporting is needed for good follow-up.Keywords:
Hysterosalpingography
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DUBOIS, F. M.D.; ICARD, P. M.D.; BERTHELOT, G. M.D.; LEVARD, H. M.D. Author Information
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The management of seven patients with colonoscopy-related perforations is described. This study demonstrates the need for an early laparotomy. A high index of suspicion is required to reach an early diagnosis. Patients with no preexisting medical problems who underwent early surgery recovered with little morbidity. In elderly patients (greater than 75 years), colonoscopic perforation can be fatal. Endoscopy should be performed with special care in such patients.
Perforation
Bowel perforation
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Histology
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Diagnostic endoscopy was applied to 188 women for sterility diagnosis. "Apparent tubal sterility" was recorded from 56 patients. Seven of them turned pregnant without therapy, though bilateral tubal occlusion had been earlier established. An attempt is made in a retrospective analysis to find out what the possible causes might have been of such "false negative" findings. Particular reference is made to spastic intramural tubal occlusion.
Tubal occlusion
Hysterosalpingography
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Introduction: This retrospective study examined the appropriate use of upper digestive endoscopy in children under 18 years of age with the “Groupe Francophone de Gastroentérologie Hépatologie et Nutrition Pédiatriques” (GFHGNP) guidelines. Methods: We reviewed the data of 293 endoscopies performed in 251 children from January 2001 to June 2003 in the Besançon teaching hospital by two senior endoscopists. The proportion of “appropriate” and “non appropriate” indications was determined according to the GFHGNP guidelines and diagnosis efficiency was compared between the two groups using the chi2 test. Multivariate analysis was performed using logistic regression. Results: 17.7% of the endoscopies performed in this series were. Relevant endoscopic diagnoses were present in 51% of cases with GFHGNP criteria versus 29% of patients without appropriate indications (OR=2.52; 95 % CI=[1.32, 4.84]; p = 4 10–3). 15 endoscopies considered non appropriate according to the guidelines provided a clinical relevant diagnosis (2 celiac diseases, 1 severe esophagitis, 4 moderated esophagitis, 6 minor esophagitis, 1 duodenitis and 1 cow’s milk allergy). In multivariate analysis, the only significant factor which could explain that some endoscopies were performed with a “non appropriate” indication was the open access type (OR= 2,51 95% CI = [1,24 – 5,08] p=0.01). Conclusion: In the majority of cases the indications of endoscopies in children are appropriate according to the GFHGNP guidelines. However, in some clinical situations where endoscopies are performed despite the guidelines clinical relevant diagnoses are found.
Esophagitis
Duodenitis
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ABSTRACT Objective To investigate the effect of induced abortion on subsequent fertility. Design 1. Prospective cohort study of women who had an unplanned pregnancy at recruitment. 2. Retrospective study of women who had a planned pregnancy at recruitment. Setting Joint Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists study based in general practice in England, Scotland and Wales, between 1976 and 1987. Subjects 1. Prospective study: Four hundred and thirty‐three women with a recruitment unplanned pregnancy ending in induced abortion (abortion group) and 1035 women with a recruitment unplanned pregnancy which ended naturally (nonabortion group). All subsequently had a planned pregnancy, or were known to be trying to conceive at some point during the follow‐up 2. Retrospective study: Nine thousand two hundred and ninety‐nine women who presented at recruitment with a planned pregnancy. Main outcome measure The women's estimated length of planning time, expressed as a fertility rate ratio. Results Induced abortion was not related to future fertility. In the prospective study, the fertility rate ratio (FRR) of the abortion group relative to the nonabortion group was 0.94 (95% CI0.83 to 1.07, P = 0.37). This result was supported by the retrospective study, which again showed no important difference between the two groups. Conclusion Induced abortion does not appear to have an important effect on future fertility.
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Hiatal Hernia
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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To estimate the prevalence and types of intrauterine abnormalities in subfertile women: a prospective study was carried out at Albayda Fertility Teaching Centre-Libya. The study was conducted on 115 infertile women attending Albayda Fertility Centre between January and May 2019. Diagnostic hysteroscopy was conducted after initial basic infertility assessment workup to assess the presence and types of uterine cavity pathologies. The duration of infertility ranged from 1-17 years, and the majority of the patients were presented with primary infertility (62.6%), 64.3% of the women had abnormal findings, and the most common lesion detected was endometrial polyp representing 44.6% of the lesions, followed by endometritis 17.6%. Seven cases had septum, and 20 patients had more than one pathology. Corrective measures were taken accordingly. 6.1% of the patients had a spontaneous pregnancy within three months of follow up. The prevalence of abnormal hysteroscopy findings among the studied population was high. Intrauterine endometrial polyps, endometritis, and uterine septum were the most frequent abnormality detected. These findings may indicate a need to incorporate hysteroscopy in the routine evaluation of infertility.
Endometritis
Abnormality
Uterine cavity
Endometrial Polyp
Hysterosalpingography
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